ABSTRACT
We examined possible predictors of the recurrence of high blood pressure (BP) in patients who remained normotensive after withdrawal of drug therapy. Thirty untreated male patients with WHO stage I essential hypertension (mean age 43 +/- 6 years) were randomly allocated to oxprenolol or nitrendipine groups. Before therapy, BP at rest, during mental arithmetic (MA) and during the cold pressor (CP) test was assessed. After 6 months of effective monotherapy, all drugs were withdrawn and casual BP was followed up for 5 months. Two weeks after cessation of therapy 26% were hypertensive again, after 4 weeks 28%, after 12 weeks 48% and after 21 weeks 74%. The two therapeutic groups did not differ in their BP increase after discontinuation of therapy. Predictors for the return of high BP were age, pretreatment BP, systolic and diastolic BP increase to the CP test. Analyses of covariance for age and pretreatment BP confirmed that reactivity to the CP test was a predictor of the return of hypertension.
Subject(s)
Antihypertensive Agents/adverse effects , Blood Pressure/physiology , Hypertension/chemically induced , Substance Withdrawal Syndrome/physiopathology , Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , Humans , Hypertension/drug therapy , Male , Middle Aged , Nitrendipine/adverse effects , Nitrendipine/therapeutic use , Oxprenolol/adverse effects , Oxprenolol/therapeutic use , PrognosisABSTRACT
We investigated whether beta-blockers or calcium-antagonists might be preferred in baseline antihypertensive therapy. In middle-aged male patients with essential BP readings did not differ between patients on Oxprenolol or on Nitrendipine (average BP: 123 +/- 12/81 +/- 14 vs. 129 +/- 17/80 +/- 10 mmHg), when clinical casual BP was within the normotensive range. Average BP at work was lower than clinical casual BP taken at the same day (125 +/- 14/80 +/- 12 vs. 133 +/- 12/87 +/-13 mmHg). A linear dependency between SBP at work and level of self reported physical activity (F(3,413) = 7.6; p less than or equal to 0.001) and arousal was found (F(3,374) = 5.2; p less than or equal to 0.02). Patients on Oxprenolol consistently had lower SBP at a particular level of physical activity and at lower levels of arousal than patients on Nitrendipine. We conclude that both regimen were equally effective as baseline antihypertensive monotherapy.
Subject(s)
Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , Hypertension/drug therapy , Nifedipine/analogs & derivatives , Oxprenolol/therapeutic use , Adult , Ambulatory Care , Blood Pressure Determination/methods , Humans , Hypertension/physiopathology , Male , Middle Aged , Nifedipine/therapeutic use , NitrendipineABSTRACT
To determine whether calcium antagonists might be used alternatively to beta-blockers in antihypertensive therapy, we investigated if monotherapy with oxprenolol (160-320 mg/day) and nitrendipine (20-40 mg/day) were equally effective on clinical casual blood pressure (BP), ambulatory BP monitoring (Remler), and BP during mental challenge (video game). In a prospective randomized long-term study, 60 white male civil servants (mean +/- SD = 43 +/- 6 years) with mild essential hypertension only were treated for at least 4 months. Average BP before therapy was 149 +/- 11/97 +/- 11 mm Hg. The antihypertensive effect was not different between the two groups (19/14 versus 21/12 mm Hg). Both groups did not differ in BP at rest, in BP during mental challenge (141 +/- 7/109 +/- 5 versus 146 +/- 9/112 +/- 8 mm Hg, NS), and average ambulatory BP monitoring at work (122 +/- 12/81 +/- 17 versus 132 +/- 14/79 +/- 17 mm Hg, NS), which was identical with the clinical casual BP. Thus, nitrendipine can effectively be used in long-term baseline antihypertensive monotherapy.
